Request for Withdrawal of Application
20 CFR 404.640
A. Justification
Introduction/Authoring Laws and Regulations
20 CFR 404.640 of the Code of Federal Regulations provides that an individual may withdraw an application for benefits before or after the Social Security Administration (SSA) makes a determination of eligibility. In some cases, the filing of an application for benefits may be to the claimants' disadvantage. The withdrawal procedure provides a method for overcoming and nullifying this disadvantage. Form SSA-521, Request for Withdrawal of Application, allows claimants to specify which application they want to withdraw and the reason for the withdrawal.
Description of Collection
Form SSA-521 collects the information required to withdraw an application for benefits. A paper SSA-521 is the preferred instrument for executing a withdrawal request. However, any written request for withdrawal signed by the claimant or a proper applicant on the claimant's behalf will suffice. Individuals who wish to withdraw their applications for benefits complete Form SSA-521, or sign the completed form for each request to withdraw. SSA uses the information from Form SSA-521 to process the request for withdrawal. The respondents are applicants for Retirement, Survivors, Disability, and Health Insurance benefits.
Use of Information Technology to Collect the Information
Form SSA-521 is available on SSA's website for individuals to print, complete, and mail to SSA for processing. SSA uses information from the form to key the withdrawal request into the Post-entitlement Online System (POS). Even though SSA processes the withdrawal request, 20 CFR 404.64 requires the claimant to sign the request with a wet signature; therefore, we cannot make this collection electronic under the Government Paperwork Elimination Act.
Why We Cannot Use Duplicate Information
The nature of the information we are collecting and the manner in which we are collecting it preclude duplication. SSA does not use another collection instrument to collect similar data.
Minimizing Burden on Small Respondents
This collection does not affect small businesses or other small entities.
Consequence of Not Collecting Information or Collecting it Less Frequently If SSA did not collect the information, we would not be able to determine if the withdrawal of the application is in the claimant's best interest. In addition, since SSA collects this information on an as needed basis, we cannot collect it less frequently. There are no technical or legal obstacles to burden reduction.
Special Circumstances
There are no special circumstances that would cause SSA to conduct this information collection in a manner not consistent with 5 CFR 1320.5.
Solicitation of Public Comment and Other Consultations with the Public
The 60-day advance Federal Register Notice published on February 9, 2012, at 77 FR 6853, and we received no public comments. SSA published the second Notice on May 17, 2012 at 77 FR 29441. If we receive comments in response to the 30-day Notice, we will forward them to OMB. We did not consult with the public in the revision of this form.
Payment or Gifts to Respondents
SSA does not provide payments or gifts to the respondents.
Assurances of Confidentiality
SSA protects and holds confidential the information it collects in accordance with 42 U.S.C. 1306, 20 CFR 401 and 402, 5 U.S.C. 552 (Freedom of Information Act), 5 U.S.C. 552a (Privacy Act of 1974), and OMB Circular No. A-130.
Justification for Sensitive Questions
The information collection does not contain any questions of a sensitive nature.
Estimates of Public Reporting Burden
Approximately 39,000 respondents take 5 minutes each to complete form SSA‑561 each year. Accordingly, the burden is 3,250 hours. This figure represents burden hours, and we did not calculate a separate cost burden.
13. Annual Cost to the Respondents (Other)
This collection does not impose a known cost burden on the respondents.
Annual Cost To Federal Government
The annual cost to the Federal Governments is approximately $472,584. This amount reflects the dollar amount for printing and distributing the collection instrument in FY 2011. It also includes an estimate for the SSA employees to process the requests.
15. Program Changes or Adjustments to the Information Collection Request
The burden reduction stems from an overinflated number SSA has used since 1991. When we realized this number might no longer be accurate, we obtained corrected figures from the Office of the Deputy Commissioner for Operations. Therefore, we are updating the burden accordingly. The figure in #12 above represents a more reliable number for computing the usage of this collection.
16. Plans for Publication Information Collection Results
SSA will not publish the results of the information collection.
17. Displaying the OMB Approval Expiration Date
OMB granted SSA an exemption from the requirement to print the OMB expiration date on its program forms. SSA produces millions of public-use forms with life cycles exceeding those of an OMB approval. Since SSA does not periodically revise and reprint its public-use forms (e.g., on an annual basis), OMB granted this exemption so SSA would not have to destroy stocks of otherwise useable forms with expired OMB approval dates, avoiding Government waste.
Exceptions to Certification Statement
SSA is not requesting an exception to the certification requirements at 5 CFR 1320.9 and related provisions at 5 CFR 1320.8(b)(3).
B. Collections of Information Employing Statistical Methods
SSA does not use statistical methods for this information collection.
| File Type | application/msword |
| File Title | Title of Information Collection and Form Number(s) |
| Author | Naomi |
| Last Modified By | 889123 |
| File Modified | 2012-05-18 |
| File Created | 2012-05-18 |